| NPI | 1730384777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 3351) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 3351) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2011-03-21 |